Dysmenorrhea (Painful Periods)

What is dysmenorrhea?

Dysmenorrhea is recurrent, crampy, lower abdominal pain that occurs during your period.  It is very common, affecting 50-90% of women at some point in their lives, usually in their teens and twenties.  It typically begins 1 or 2 days before or with the start of a period and improves over the 2nd and 3rd day of bleeding.  It is common to experience mild nausea, diarrhea, back pain, headache, and/or dizziness along with the pain.

What can I do to reduce this pain?

 The first things to try are:

  • Applying heating pad/heat pack applied to lower abdomen
  • Exercising
  • Staying very well hydrated (women need about 9 cups or 2.2 liters of fluids a day)
  • Ibuprofen 400mg-600mg by mouth every 4-6 hours starting a day or two before you anticipate your period will begin and continue until pain resolves.
  • Magnesium 250mg by mouth at bedtime starting a day or two before you anticipate your period and continuing until pain resolves
  • Begin taking a daily Fish Oil supplement (Barlean’s brand recommended)

If these conservative measures are not helping, discuss the following options with your provider:

  • Prescription strength NSAIDS (ibuprofen-like medicine) called Ponstel
  • Progesterone support during the luteal phase of the cycle (the part of your cycle after ovulation occurs until your period begins)
  • Low-dose Naltrexone which is a medicine that is considered more experimental for treating painful periods, but shows some promise with few side effects
  • Proceeding with a diagnostic laparoscopy to look for problems with the anatomy of the pelvis, especially endometriosis (a disease of the female pelvis that can only be officially diagnosed with surgery).

 

Please visit http://obgyn.slu.edu/index.php?page=endometriosis-diet-for-adults for information on dietary considerations for patients with endometriosis/inflammatory conditions.